Tumor Volume Does Not Predict for Biochemical Recurrence After Radical Prostatectomy in Patients with Surgical Gleason Score 6 or Less Prostate Cancer

Megan M. Merrill, Brian R. Lane, Alwyn M. Reuther, Ming Zhou, Cristina Magi-Galluzzi, Eric A. Klein

Research output: Contribution to journalArticle

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Abstract

Objectives: No consensus exists regarding the prognostic value of tumor volume (TV) in predicting biochemical recurrence (BCR) of prostate cancer, especially late in the prostate-specific antigen (PSA) era. We assessed this relationship in a large cohort of patients treated at one institution with standardized pathologic assessment from 1998 to 2005. Methods: Data were collected for 1833 patients undergoing radical prostatectomy for clinically localized prostate cancer since 1998. Patients receiving neoadjuvant or adjuvant therapy or with node-positive disease were excluded. Along with the routine pathologic assessment, TV was prospectively assessed in all specimens. BCR was defined as two consecutive PSA levels of 0.2 ng/mL or one PSA level of greater than 0.2 ng/mL. Results: Although a larger TV correlated with lower rates of biochemical relapse-free survival in patients with a surgical Gleason score of 7 (P <0.0001) and surgical Gleason score of 8 or greater (P = 0.0459), the biochemical relapse-free survival rate at 4 years for low, medium, and extensive surgical Gleason score 6 or less tumors was 95%, 96%, and 97%, respectively (P = 0.65). In a multivariate model, including TV, initial PSA, EPE, seminal vesicle invasion, and surgical Gleason score, the TV predicted for BCR (P = 0.0176). Conclusions: The results of this large study suggest that a large TV is an independent predictor of BCR in patients with tumors of specimen Gleason score 7 or higher. In contrast, most grade 6 tumors will be organ confined, even if of high volume, and TV will not predict for BCR in these patients.

Original languageEnglish (US)
Pages (from-to)294-298
Number of pages5
JournalUrology
Volume70
Issue number2
DOIs
StatePublished - Aug 1 2007

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Neoplasm Grading
Prostatectomy
Tumor Burden
Prostatic Neoplasms
Recurrence
Prostate-Specific Antigen
Neoplasms
Seminal Vesicles
Survival Rate
Survival

ASJC Scopus subject areas

  • Urology

Cite this

Tumor Volume Does Not Predict for Biochemical Recurrence After Radical Prostatectomy in Patients with Surgical Gleason Score 6 or Less Prostate Cancer. / Merrill, Megan M.; Lane, Brian R.; Reuther, Alwyn M.; Zhou, Ming; Magi-Galluzzi, Cristina; Klein, Eric A.

In: Urology, Vol. 70, No. 2, 01.08.2007, p. 294-298.

Research output: Contribution to journalArticle

Merrill, Megan M. ; Lane, Brian R. ; Reuther, Alwyn M. ; Zhou, Ming ; Magi-Galluzzi, Cristina ; Klein, Eric A. / Tumor Volume Does Not Predict for Biochemical Recurrence After Radical Prostatectomy in Patients with Surgical Gleason Score 6 or Less Prostate Cancer. In: Urology. 2007 ; Vol. 70, No. 2. pp. 294-298.
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abstract = "Objectives: No consensus exists regarding the prognostic value of tumor volume (TV) in predicting biochemical recurrence (BCR) of prostate cancer, especially late in the prostate-specific antigen (PSA) era. We assessed this relationship in a large cohort of patients treated at one institution with standardized pathologic assessment from 1998 to 2005. Methods: Data were collected for 1833 patients undergoing radical prostatectomy for clinically localized prostate cancer since 1998. Patients receiving neoadjuvant or adjuvant therapy or with node-positive disease were excluded. Along with the routine pathologic assessment, TV was prospectively assessed in all specimens. BCR was defined as two consecutive PSA levels of 0.2 ng/mL or one PSA level of greater than 0.2 ng/mL. Results: Although a larger TV correlated with lower rates of biochemical relapse-free survival in patients with a surgical Gleason score of 7 (P <0.0001) and surgical Gleason score of 8 or greater (P = 0.0459), the biochemical relapse-free survival rate at 4 years for low, medium, and extensive surgical Gleason score 6 or less tumors was 95{\%}, 96{\%}, and 97{\%}, respectively (P = 0.65). In a multivariate model, including TV, initial PSA, EPE, seminal vesicle invasion, and surgical Gleason score, the TV predicted for BCR (P = 0.0176). Conclusions: The results of this large study suggest that a large TV is an independent predictor of BCR in patients with tumors of specimen Gleason score 7 or higher. In contrast, most grade 6 tumors will be organ confined, even if of high volume, and TV will not predict for BCR in these patients.",
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AU - Magi-Galluzzi, Cristina

AU - Klein, Eric A.

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